Abortion
Abortion (sometimes called termination) is the surgical or medical ending of a pregnancy. It has been legal since 1967 and is legally available up to 24 weeks of pregnancy (or beyond if a disability is diagnosed). Abortions can take place in NHS hospitals or in private clinics. Most abortions take place around 10-12 weeks of pregnancy. About 180,000 abortions are done each year in this country. It is illegal in Northern Ireland.
How is an abortion done?
There is a variety of ways that abortion is done:
Medical abortion:
This procedure can only be done under 9 weeks of pregnancy and is not usually given to women over 35.
It involves taking two drugs at an interval of 48 hours. The first drug given makes the lining of the womb unsuitable for the developing baby. After this, the woman can go home.
The second drug, given 48 hours later, causes the womb to contract. This leads to the breakdown of the lining of the womb and the loss of the embryo through bleeding from the vagina. This part can be painful. Women are quite often on their own at home for this part of the abortion.
Surgical abortion:
Up to 14 weeks of pregnancy, a suction method (called vacuum aspiration) can be used. The woman is usually given a general (but sometimes a local) anaesthetic. A suction tube is inserted into the womb and the developing baby (foetus) is sucked out. After this, a woman usually bleeds for up to 14 days.
Up to 19 weeks of pregnancy, the developing baby is larger so surgical dilatation and evacuation (D&E) is used. This means that, under general anaesthetic, the opening of the woman's womb is stretched open and forceps (a metal tool) are used to remove the developing baby. Again, bleeding may occur afterwards for up to 14 days.
After 20 weeks of pregnancy, there are two methods of abortion available:
The first involves injecting the developing baby to stop its heart or cutting the umbilical cord to ensure that it is dead. The next day, a dilatation and evacuation procedure (as described above) is done to remove it in parts from the womb. The woman is under general anaesthetic for both parts of this abortion and usually has to stay in for at least one night.
The second involves going through induced labour. Again, the heart is stopped so that the baby is not born alive. An injection of prostaglandin is given to the woman to make her womb contract and she eventually delivers the dead baby. As she is awake for this procedure, pain relief is given. The woman stays in for at least one night.
What are the health risks?
The risks to physical health include infection (up to 10% of cases); haemorrhage (bleeding) (in 1.5 per 1000 abortions); perforation of the womb (about 1-4 per 1000 abortions); damage to the cervix (up to 1% of abortions). If complications ensue, especially infection, relative infertility is not rare. Total infertility is rarer but does occur. Other problems include a higher risk of ectopic pregnancy, miscarriage and premature labour in later pregnancies. There have been suggestions that abortion is linked to breast cancer.
How will I feel about it afterwards?
Many women initially feel relieved after an abortion because they feel that the problems are solved. Some naturally feel sadness about the abortion but, over time, cope with it in a way that’s acceptable to them.
However, there are many who do not cope and who experience various symptoms of what is now known as post-abortion stress.
You may experience these symptoms if you are unsure or ambivalent about having an abortion. For example, you may
- be pressurized by someone into the decision;
- feel as if you have no choice because circumstances feel overwhelming;
- be pregnant with a wanted baby but feel you have to abort because a disability
has been diagnosed;
- have strong motherly feelings or maternal instinct;
- have been depressed before or
- do not feel very comfortable with the idea of abortion.
You may feel a combination of any of the above.
Symptoms of post-abortion stress can include:
- Emotions such as guilt, grief, sense of loss and anger.
- Feeling the need to ‘replace’ the baby.
- A feeling of distance from existing children.
- Inability to maintain normal routine
- Depressed feelings that are stronger than ‘a little sadness’
- Sleeping problems
- Flashbacks
- Tearfulness
- Disturbing dreams or nightmares
- Inability to be near babies or pregnant women
- Preoccupation with
thoughts of deceased
Physical Symptoms can include Hyperventilation, Sweating, Difficulty Swallowing and breathing
In severe cases, a woman can become suicidal, self-harming, indulge in risk-taking behaviours, become dependent on drugs or alcohol or suffer anxiety or panic attacks.
These symptoms can occur at any stage after an abortion, sometimes triggered by another loss later on.
What do I need to think about as I make a decision about having an abortion?
Abortion is not always the easy quick-fix decision that it can appear to be. It can feel like: 'If I end the pregnancy, I end the problem'. But abortion can create problems – emotional and physical - of its own.
In the urgency of a crisis pregnancy, abortion often feels like the only way out of difficult circumstances, but not many people know very much about it.
It is hard to face the fact that abortion results in the death of a developing baby, but this needs to be taken into account in your decision making process. This may be painful for you to realise but it is better to consider it now rather than later.
It is so important to understand fully what's involved - in abortion itself as well as baby development - so that you can make a decision based on accurate information and not feelings of panic or fear.
Know Your Options
We have all been given the ability to make choices with dignity and self-respect. It is wise to pay attention to your own deeper feelings - your conscience, instinct and beliefs, not just the difficult circumstances - before you make a decision.
The options to keep the baby or make an adoption plan for your baby are very positive choices and ones that may bring you greater health and well-being in the long run. It is important that you take time to consider these as well.
Click for What about Adoption? and What about having a baby?
Talk to someone about it who can give you accurate information and help you talk through the issues affecting you.
A Choices advisor is available on 0800 123 45678 or online here.
